Michigan-specific Medicaid spend-down rules
Michigan administers Medicaid through the Department of Health and Human Services (MDHHS). Long-term care applications start at your county MDHHS office in places like Detroit, Grand Rapids, Lansing, Ann Arbor, and across Wayne County.
Nursing facility Medicaid requires a Michigan Medicaid Nursing Facility Level of Care Determination (LOCD) before MDHHS approves the stay. MI Choice waiver slots cover certain home-based services, but asset tests still follow the same $2,000 resource standard for the applicant.
Michigan does not offer a broad medically needy income spend-down for nursing facility cases the way Pennsylvania does. Families above the $2,901 monthly income cap must assign excess funds to a Qualified Income Trust with a Michigan trustee. Community applicants may use the $1,330 MNIL for income spend-down on other Medicaid categories.
MI Health Link serves full-benefit dual eligibles in certain counties through managed care plans. Nursing facility applicants outside that program usually stay on fee-for-service Medicaid, but the $2,000 asset cap still applies.
Community spouses may keep the greater of the CSRA calculation or certain income protections under spousal impoverishment rules. The state uses the federal maximum home equity cap of $713,000 in 2026 unless a spouse or dependent child still lives in the house.
Burial spaces, one vehicle, and up to $1,500 in a designated burial fund can be excluded if titled correctly. Prepaid funeral contracts follow separate MDHHS policy memos.
Look-back reviews cover asset transfers made within 60 months before application. Penalty length equals the uncompensated transfer amount divided by the average monthly nursing facility cost published by MDHHS.
Rural applicants in the Upper Peninsula follow the same resource test as families in Oakland and Macomb counties. MI Choice wait lists vary by region, but the $2,000 asset cap does not.
Common mistake: Assuming Michigan exempts a second home because it is "in the family." Non-homestead real estate counts unless occupied by a spouse or dependent child under MDHHS rules. Budget property taxes and sale costs before you rely on an appraisal.